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Diet and the microbiome-gut-brain axis: A primer for clinical nutrition -…
Diet and the microbiome-gut-brain axis: A primer for clinical nutrition
Introduction
Randomized clinical trials (RCT) that are currently used have vague standards for symptoms and evaluations
Recommend establishing informative and robust dietary assessment protocols
The overall influence of diet on mental health is largely unknown
Results
Indicators for gut health established from previous studies outlined in this research article
Many observational studies have observed the influence of diet on mental health without being able to produce data
Major depressive disorder patients experienced a Mediterranean-like diet intervention that resulted in improved symptoms in comparison to the control group that was only provided a companion
Fermented food diet has been shown to improve gut health without evaluation of mental health
Measured by the presence of SCF, higher contents of saturated fats, salt, and sugar suboptimally alters gut microbiota resulting in low-grade systemic inflammation
Diet related approaches have resulted in and increase in butyric acid producing genres in the gut and also observed mediated effects of epilepsy in rats and children
Small chain fatty acids (SCF) have been previously evaluated for indicating gut health in psychiatric patients, but are limited to communicating with the hypothalamus which is responsible for feeding behavior and energy balance.
Intermittent fasting studies have also revealed an increase in butyric acid producing genera in gut
Gut bacteria metabolize signaling neurotransmitters that stimulate the autonomic system or vagaries sensory neurons that communicate with the hypothalamus, nucleus accumbens, and ventral tegmental area
Key points
Assessing dietary intake and adherence
Standardized protocols
Intra-individual variability in microbiome
Suggestions
Nutrional bio markers
Urine - potassium and iodine
Plasma - selenium, zinc, vitamin carefully and vitamin B 12
Serum - calcium phosphorus, magnesium, iron, zinc, vitamin D, vitamin E, and vitamin C
Specific markers - phytochemicals, carotenoids, caffeine metabolites, flavones, isoflavones , and phytosterols
Current analysis
Direct or self reporting adherence to dietary standards? A combination is ideal
Currently using self reporting primarily as a Food Frequency Questionnaire (FFQ)
Pros - cheaper, faster, and smaller population of participants
Cons - higher misreports
Assessment tools should be selected for the best fit for the bio active compound of interest
Evaluating for polyunsaturated fatty acids showed no difference in the use of FFQ or 7 day food diary
7 day food diary is much more effective for reporting for Vitamin C
Abstract
Recent findings
Pathways of modulation should be viewed through a clinical nutrition lens
Mediterranean-like diets have revealed beneficial effects on symptoms of depression
Fermented foods have revealed beneficial effects on immunity
Summary
Effective modulation of the brain process and diet can reveal relationships and suggest opportunities for novel dietary interventions to treat mental health
Purpose
Diet induced microbiome states can impact the brain health and behavior
Key words
Diet
Mental health
Clinical nutrition
Microbiota-gut-brain axis
Discussion
Methods require specific standards and methodology
Length of dietary intervention and outcomes need to be defined
Defined population and size
Current limitations of diet-microbe studies prevent the ability to further understand the influence on mental health
Defined nutrional modulations
Methods
Evaluated 51 nutrional studies to establish strengths, weaknesses, and suggestions for improving future studies
Ribeiro G, Ferri A, Clarke G, Cryan JF. Diet and the microbiota - gut - brain-axis: a primer for clinical nutrition. Curr Opin Clin Nutr Metab Care. 2022 Nov 1;25(6):443-450. doi: 10.1097/MCO.0000000000000874. Epub 2022 Sep 14. PMID: 36102353; PMCID: PMC9553262.